Long-term-care homes welcome emergency staffing order at a critical point in the pandemic

It was a difficult week for residents and staff at St. Clair O'Connor Community in East York, as COVID-19 continues to take a heavy toll on seniors in long-term health-care facilities and the people working in them.

Four residents, ranging in age from 85 to 91, died this past week from the coronavirus.

"The residents that did pass were able to connect with their families prior" using FaceTime, Zoom and Skype, said Mary Hoare, chief executive officer of the facility. "It was really very painful, but it was very satisfying for those families."

In addition, 14 residents in the 25-bed facility are showing signs of the illness, as are seven staff members. The grim story is similar across the province with nearly 50 deaths in long-term-care facilities, and close to 80 of the province's roughly 750 retirement homes reporting cases of COVID-19.

Pinecrest in Bobcaygeon has been the hardest hit with 22 deaths. Eight residents have died at Seven Oaks in Scarborough, the most in the GTA.

Facilities such as St. Clair O'Connor Community are fighting the pandemic short-handed. Many staff members are at home in self-isolation and will only be allowed to return to work after passing two COVID-19 tests within a 24-hour period.

"Public health is following them," said Hoare. "Staffing has been difficult because of the staff that are away (due to sickness). We have been managing. They all have protective equipment on."

Help is on the way. On Friday, the province issued a temporary order - under the Emergency Management and Civil Protection Act - that will help retirement homes address emergency staffing needs, giving them more flexibility to recruit and reassign workers. The order breaks down the wall between job titles, allowing nurses, personal support workers and others inside the facility to do work beyond their strict roles.

"We need them to be able to respond in the moment," said Donna Duncan, CEO of the Ontario Long Term Care Association. "It's a challenging time for everybody. We had a critical labour shortage before the pandemic, so this special order is fundamentally important for us."

Duncan says her organization and others like it might need as many as 30,000 temporary workers over the next six months, drawn from a labour pool that could include: dental hygienists qualified in health care; laid-off cleaners from the hotel industry; and certified food handlers from the restaurant industry.

"We know there's a workforce out there not working right now who could provide temporary support," said Duncan.

The issues at seniors homes are broad. Hoare said her facility has had "difficult conversations" with families of residents "about what would happen if their loved one got COVID and what decisions they would have to make in terms of their care.

"We were lucky enough to have obtained direction from all families with what to do. We've got that well covered. And we make sure the families of the residents are called every single day, because they can't come in to visit."

Lawyer and seniors advocate Laura Tamblyn Watts says some families wonder if leaving their loved ones in these facilities is the right thing to do during a pandemic. She has come up with a checklist to help them decide.

"The situation is dire in long-term care, but people need a practical tool to help them think through whether they're making things worse by bringing their loved one home," said Tamblyn Watts. "It's a really serious consideration.

"There may be an emotional desire to do that, but there's a practical challenge to it. In order to get into long-term care, you have to have such a degree of frailty and need that most people can't take care of them at home, so that's why they're there to begin with."

Some of the questions on the list are more practical: bathroom accessibility, whether bed rails are needed. Others are medical: proximity to a doctor, physiotherapy, safety for someone with dementia.

Tamblyn Watts says the number of COVID-19 deaths and cases is likely much higher than reported because seniors are a low priority for testing.

"They will test up to three people and that's it. After that, everyone is assumed to have it. We have no actual data - this real number - for how many deaths there are in long-term care," said Tamblyn Watts. "With the limited number of testing kits, long-term care is at the bottom of people's priority list and the top of their hearts and minds."

Kevin McGran is a reporter based in Toronto. Follow him on Twitter: @kevin_mcgran